Network Prior Auth & Referral Specialist
Company: St. Luke's University Health Network
Location: Allentown
Posted on: May 25, 2023
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Job Description:
St. Luke's is proud of the skills, experience and compassion of
its employees. The employees of St. Luke's are our most valuable
asset! Individually and together, our employees are dedicated to
satisfying the mission of our organization which is an unwavering
commitment to excellence as we care for the sick and injured;
educate physicians, nurses and other health care providers; and
improve access to care in the communities we serve, regardless of a
patient's ability to pay for health care.The Network Prior
Authorization and Referral Specialist is responsible for the
coordination of prior-authorizations and referral process for
patients being referred for specialty care, diagnostic procedures,
and surgery. Performs scheduling, insurance verification, obtaining
pre-authorizations, and referrals. Ensures notification of
reimbursement to physicians, nurses, financial clearance staff, and
patients prior to services being rendered.
JOB DUTIES AND RESPONSIBILITIES:
Sitting for up to 8 hours per day, 3 hours at a time.-- Consistent
use of hands and fingers for typing, telephones, data entry,
etc.---- Occasional twisting and turning.-- Uses upper extremities
to lift and carry up to 15 pounds.---- Stoops, bends, and reaches
above shoulder level to retrieve files.-- Hearing as it relates to
normal conversation.-- Seeing as it relates to general vision.--
Visual monotony when reading reports and reviewing computer
screen.
EDUCATION:
High School diploma or equivalent required.
TRAINING AND EXPERIENCE:
One to two years of experience in medical billing office, medical
setting or insurance company.-- Working knowledge of medical
business office procedures and basic accounting and detailed
understanding of ICD-10 and CPT codes. Strong knowledge of
regulatory standards and compliance requirements.---- Previous
pre-certification experience helpful.-- Previous Medical Assistant
experience highly desirable.
Please complete your application using your full legal name
and--current home address. --Be sure to--include--employment
history for--the past seven (7) years, including your present
employer.-- Additionally, you are--encouraged to upload a current
resume, including all work history, education, and/or
certifications and--licenses, if applicable. --It is highly
recommended that you create a profile at the conclusion of
submitting your first application. --Thank you for your interest in
St. Luke's!!
Keywords: St. Luke's University Health Network, Allentown , Network Prior Auth & Referral Specialist, Other , Allentown, Pennsylvania
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